To be considered for the position of Communications Officer you will be asked to participate in the following:
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- Camilla Marilynn Whitehead
- 7 years ago
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1 Dear Communications Officer Applicant: Thank you for your interest in the position of Communications Officer with Athens- Clarke County Police Department. Enclosed you will find the information and application for this position. Please provide all information that is requested. Failure to do so could disqualify you from consideration for this position. To be considered for the position of Communications Officer you will be asked to participate in the following: Typing Test (20 words per minutes with 90% accuracy is required) Public Safety Telecommunications Test At a later date you may be asked to participate in further testing, i.e. polygraph examination, medical examination (including a routine drug screen), and psychological examination. Our hiring process for a Communications Officer position generally ranges from four to six months. Successful completion of all of the phases of selection is necessary for eligibility for employment; but NOT a guarantee of employment. Should an applicant fail any portion of the application process, he/she will be notified in writing of the necessary steps to re-apply, as eligible, for employment with Athens- Clarke County. If an applicant is deferred, his/her application will remain on file for one year from the date of receipt. Should that one year period expire, the applicant may reapply. Again, thank you for your interest in employment with the Athens-Clarke County Police Department. If you have any questions, please call Respectfully, Unified Government of Athens-Clarke County Human Resources Department 1
2 Communications Officer ATHENS-CLARKE COUNTY POLICE DEPARTMENT APPLICATION FOR EMPLOYMENT INSTRUCTIONS AND INFORMATION PLEASE READ CAREFULLY BEFORE BEGINNING 1. Please print or type all information you list in this application. 2. You will not be considered for employment with the Athens-Clarke County Police Department if any of the following exists: a. conviction in any court for any felony offense. b. conviction in any court for any drug related offense c. any pending criminal action in any court d. presently under investigation for any criminal offense by this or any other law enforcement or criminal justice agency e. less than 18 years of age at time of application f. if you are not eligible to work in the United States because you are not a U.S. citizen * An applicant who has received an official pardon or other similar action for any offense or applicable condition as stated above, is not obligated to disclose the offense or condition in this application. If, however, during the course of a background investigation, facts are discovered regarding the offense or condition, the applicant may be required to produce proof of such pardon or action to remain in consideration for employment. 3. If you have any questions regarding this application, contact the Human Resources Department at The following is a checklist for your convenience. We urge you to use it, as an incomplete application may not be processed. Upon completion of the application, refer to this checklist to make sure no information has been omitted. All questions are answered. Those not applying to me are marked N/A" or No. The application is signed and dated. I have attached a copy of the following documents: Recent Photograph Copy of Birth Certificate Copy of DD-214 (if applicable) Copy of High School Diploma or State Issued GED Copy of Driver s License Copy of Social Security Card 2
3 AUTHORITY TO RELEASE INFORMATION TO ATHENS-CLARKE COUNTY POLICE DEPARTMENT To Whom it May Concern: I hereby authorize the Athens-Clarke County Police Department or other authorized representative of the Athens-Clarke County government bearing this release, or copy thereof, within one year of its date, to obtain any information in your files pertaining to my employment and/or educational records, including but not limited to, academic achievement, attendance, athletic, and disciplinary records. I hereby direct you to release such information upon request of bearer. This release is executed with full knowledge and understanding that the information is for the official use of the Athens-Clarke County Police Department. Consent is granted for the Athens-Clarke County Human Resources Department to furnish such information as is described above, to third parties in the course of fulfilling its official responsibilities. I hereby release you, as the custodian of such records, and any school, college, university, or their education institution, or other consumer reporting agency, or retail business establishment including its officers, employees, or related personnel, both individually or collectively, from any and all liability for damages of whatever kind, which may at any time result to me, my heirs, family or associates because of compliance with this authorization and request to release information, or any attempt to comply with it. Should there be any questions as to the validity of this release, you may contact me at the address indicated below. I understand that my application will be subject to verification through a comprehensive background investigation, a part of which may be a polygraph. Falsification and/or misrepresentation of facts during any phase of the employment process will be grounds for termination of applicant s employment process and/or dismissal. FULL NAME: (signature) FULL NAME: (print or type) PHONE NUMBER: CURRENT ADDRESS: DRIVER S LICENSE NUMBER: STATE 3
4 ATTACH BIRTH CERTIFICATE In lieu of a birth certificate, a valid Georgia Driver s License plus one or more of the following documents may be accepted: a. Baptismal record b. Draft card c. Court records d. Passport e. Citizenship papers f. Armed Forces discharge paper (DD214) g. Certified copy of school records This identification must show the full name and date of birth of the applicant. In order to establish the place of birth, an applicant must also submit a signed, notarized statement indicating that he is a United States citizen if documents other than a birth certificate are furnished. Included in this statement must be the place, date and county of birth. If the applicant is a naturalized citizen, a certified copy of the naturalization papers is to be sent with the statement. 4
5 MILITARY SERVICE ATTACH MILITARY DISCHARGE OR DD-214 SHOWING TYPE OF DISCHARGE HERE 5
6 ATTACH COPY OF DRIVER S LICENSE HERE ATTACH COPY OF SOCIAL SECURITY CARD HERE ATTACH RECENT PHOTOGRAPH HERE 6
7 PREVIOUS ADDRESSES List the information requested regarding all addresses at which you have resided within the past 10 years, excluding present address. Begin with the most recent. Attach additional page if necessary. Address: From/to Own or Rent? If rent, list landlord s name: Roommates: Address: From/to Own or Rent? If rent, list landlord s name: Roommates: Address: From/to Own or Rent? If rent, list landlord s name: Roommates: Address: From/to Own or Rent? If rent, list landlord s name: Roommates: Address: From/to Own or Rent? If rent, list landlord s name: Roommates: 7
8 PUBLIC SAFETY EMPLOYMENT HISTORY Name/Address/Phone Number of Employer From month/year to month/year Position Reason for Leaving ******************************** Name/Address/Phone Number of Employer From month/year to month/year Position Reason for Leaving ********************************* CRIMINAL RECORD Convictions (felonies, misdemeanors, either civilian or military): Crime Court Date Disposition of case (dismissed, paid fine, probation) ********************************* Convictions (traffic, including pleas of guilty and nolo contendere) Crime Court Date Disposition of case (dismissed, paid fine, probation) 8
9 COMMUNICATIONS/911 EMPLOYMENT HISTORY NOTICE: COMPLETE THIS SECTION ONLY IF YOU ARE CURRENTLY OR HAVE BEEN A PUBLIC SAFETY COMMUNICATIONS OFFICER/911 or EMS DISPATCHER. Are you currently a communications officer/dispatcher? Yes No If yes, continue:,, State of Certification Certification Date # years dispatching experience Types of Certification: Basic Dispatch GCIC Certification ( Full or Practitioner) Advanced Dispatch Is your certification current? Yes No (Attach copies of certifications and re-certifications) Have you ever been the subject of an internal investigation? Yes No Check any of the following areas in which you have received specialized training: Computer/Typing Skills Communications/911 Experience Stress Management Supervision Report Writing Other Do you have any other certifications/experiences pertinent to this position?: 9
10 In the space provided below, give a brief biography or history of yourself. Begin with your past, bring yourself into the present, and project yourself into the future. Tell where you were born, where you grew up, significant experiences and what you have done with your life so far. Tell something about your hobbies, special interests and any other subject which zeros in on your individuality. If you need additional space, attach a separate sheet to the application. LIST ALL OTHER ADULTS CURRENTLY LIVING IN HOUSEHOLD. ****NOTICE: EACH ADULT LISTED HAS TO SIGN A CRIMINAL HISTORY RELEASE FORM. 10
11 POSITION REQUIREMENTS: This position may require you to: Wear a uniform. Do you object to doing so? Yes No Work a rotating shift. Do you object to doing so? Yes No Work overtime. Do you object to doing so? Yes No FINGERPRINT HISTORY: If you have ever been fingerprinted by a police agency other than for an arrest, give details below. Your answers will be checked with the F.B.I. and other agencies. Agency: Date: Purpose: Agency: Date: Purpose: ILLEGAL SUBSTANCE USE Have you ever tried or used marijuana? Yes No If yes, when was the date you last tried or used marijuana? How many times have you tried or used marijuana in your lifetime? What were the circumstances? Have you ever tried or used any other illegal drugs or used legal drugs in an illegal manner? Yes No If yes, what was/were the drug(s)? How many times have used this/these drug(s) in your lifetime? What were the circumstances? 11
12 EMPLOYMENT HISTORY: Have you ever been fired from or permitted to resign employment for breach of trust, embezzlement, theft, or any other crime? Yes No Have you ever been fired from or permitted to resign employment for abuse of authority or for any disciplinary reasons? Yes No I HEREBY CERTIFY THAT ALL STATEMENTS MADE IN THIS QUESTIONNAIRE ARE TRUE AND COMPLETE, AND UNDERSTAND THAT ANY MISSTATEMENTS OF MATERIAL FACTS WILL SUBJECT ME TO DISQUALIFICATION AS AN APPLICANT, OR DISMISSAL IF HIRED. Date completed Signature 12
13 Please complete with application. PRE-EMPLOYMENT QUESTIONS POLYGRAPH EXAMINATION GENERAL QUESTIONS: 1. Have you told me your correct name? Have you told me your correct age? Have you ever had a polygraph test before? Have you taken any drugs or medicine today? Have you been truthful about your military record? Are you eligible to work in the United States? Have you been truthful about your education? Do you live at the address listed on this application? Do you ever drink on the job? YES NO RESPONSIBILITY AND STABILITY QUESTIONS: 10. Do you feel qualified for this job? Are you seeking permanent employment? Have you ever been fired for dishonesty? Have you ever quit a job without required notice? Have you falsified any part of your application? Have you told the truth about your employment? Did you deliberately leave any employer off your application? Do you want this job for any reason other than employment? SECURITY QUESTIONS: 18. Have you ever tried or used narcotics, drugs or marijuana illegally? Have you knowingly cashed a bad check? Did you ever forge a check? Did you ever steal merchandise or materials from an employer? Did you ever steal money from your employer? Did you ever participate in a theft ring? Did you ever commit a serious, undetected crime? Are you wanted by a law enforcement agency? Have you ever been arrested? Have you ever been in jail or prison? Have you ever been refused by a bonding company? Are you now on probation or parole? Have you ever been involved in a criminal offense? Have you ever committed any act that would leave you for pressure or blackmail? Signature 13
14 ATHENS-CLARKE COUNTY, GEORGIA REFERENCE RELEASE STATEMENT I authorize the addressed individual, company, or institution to furnish Athens-Clarke County Government with any information that they may have concerning me which they have on record or otherwise; and I release such individual, company, or institution and Athens-Clarke County Government from any and all liability for any damage whatsoever incurred in furnishing such information. A photocopy of my signature on this page will suffice as an original. Printed Name of Applicant Signature of Applicant Applicant do not write below this line Date of Signature To: From: Attn: Phone: Fax: (706) The job applicant named above has applied for employment with an agency of Athens-Clarke County Government and lists your organization as a present or previous employer. We would very much appreciate your help and cooperation by candidly evaluating this applicant s performance while employed by your organization. You may return this form to us by mail (address above), by FAX, or call our representative named above. PLEASE RATE THE FOLLOWING: EXCELLENT GOOD FAIR POOR Responsiveness to Supervision Cooperation Quality Quantity of Work Timeliness of Work Attendance/Punctuality Dates of employment: from: to: Position: Reason for leaving: Would you reemploy? If no, why not? Other pertinent comments Completed by: Date: * * * * * *Thank you for your time and cooperation* * * * * *
15 ATHENS-CLARKE COUNTY UNIFIED GOVERNMENT RELEASE OF CRIMINAL HISTORY CONSENT FORM I, Last Name First Name Middle Social Security Number Height Weight Eye Color Hair Color Date of Birth Sex Race Street Address City State Zip Authorize: Athens-Clarke County Unified Government Authorized Human Resources Representative Satula Governmental Building, 375 Satula Avenue Athens, Georgia (706) to receive my criminal history record from the NCIC/GCIC database. I understand this request will only be used for employment purposes. Employment provisions (check all that apply): Signature Date * Signature of Parent/Guardian Date * Parental/Guardian consent is required for applicants under age 18. General Employment (Purpose code E ) Employment with children (Purpose code W ) Employment with criminal justice agency civilian (Purpose code J ) (i.e. police dept. records technicians, intake clerks) Employment with criminal justice agency P.O.S.T. certified (Purpose code Z ) (i.e. Police Officer, Deputy Sheriff, Correctional Officer, Probation Officer, Communications Officer) Where information provided through your criminal history indicates criminal charges outside the state of Georgia, it is your responsibility as an applicant to provide the Athens-Clarke County Human Resources Department with a copy of all criminal history records in all other applicable states. Failure to provide the required information may result in the disqualification of your application. ************************************************************************************** If hired, I,, authorize the Athens-Clarke (print name) County Human Resources Department to perform periodic Criminal History background checks for the duration of my Employment with this agency.
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